NBME 9 Review Exam Questions with 100% Correct Answers

Who should receive PCV13 vaccine? Correct Answer Patients with HIV, lymphoma, leukemia, multiple myeloma, functional or anatomic asplenia, ESRD, cochlear implants, CSF leaks, hx solid organ transplant, immunodeficiencies Post-transplant lymphoproliferative disorder Correct Answer EBV (monoclonal B lymphocytes) Type of cells increased in multiple myeloma Correct Answer B cells (monoclonal spike) -- multiple myeloma is a disorder of plasma cell proliferation; plasma cells are terminally differentiated B cells, thus it is considered a B-lymphocyte malignancy Alk phos levels in hemolysis Correct Answer Normal (alk phos is elevated in the case of biliary obstruction -- hemolysis occurs before this point) Medication options for acute depression in a patient with bipolar Correct Answer Lithium, lamotrigine, quetiapine, lurasidone How to diagnose botulism Correct Answer Repetitive nerve stimulation studies (electromyography) -- improves with repeated stimulation Prevention of stroke in a patient with a fib Correct Answer Warfarin (anticoagulation) Vestibular neuronitis Correct Answer Inflammation of vestibular portion of cranial nerve VIII - commonly after viral infection Acute vertigo, nausea, vomiting, nystagmus (horizontal or rotary), gait instability -- episodic! Basilar migraine Correct Answer Begins with brainstem aura symptoms - vertigo, incoordination, tinnitus, hearing loss, diplopia, dysarthria Symptoms last only a few minutes to an hour and are followed by headache (occipital) Treatment of diaper candidiasis Correct Answer Topical nystatin JIA - female child with oligoarthritis and positive ANA titers; what should you evaluation Correct Answer Slit-lamp evaluation (uveitis is common and often asymptomatic until it has led to complications) Treatment SVT Correct Answer 1 - adenosine, vagal maneuvers